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no drugs for you! unless you want an overdose…?

I saw this little tid-bit on HotAir today:

One patient in Oregon got a letter that made this all too clear, when in the same letter rejecting her request for life-extending chemotherapy, Oregon offered her “physician-aid-in-dying”. In other words, Oregon offered their customer a heapin’ helping of death:


Yikes, *sorry, no drugs for you, but we can help you commit suicide*. I think this is what Obama was talking about when he said maybe a pill is best?

When it comes to health care reform, I have listened to both sides of the debate, and can agree with portions of both arguments. Living in Italy, where we have socialized medicine, I also see the good and the bad with this type of system. For the most part, I have stayed out of the health care reform issue. I believe the American people should be *the deciders* on this important issue. But, I am pissed when the Senate scoffs at reading the bills, and I worry about the attempts to pass this so quickly.

I have had a lot of discussions with family and friends, and hear opinions from all points of view. I think the most important thing is that people fully understand what these changes mean – financially and as far as actual coverage. And when members of Congress, and Obama don’t even know what is being proposed, that worries me.

Supporters of the health care reform like to say that people go to Canada for healthcare, and deny that people travel to the US for care. People travel to the US ALL the time seeking better care. Some Americans may travel to Canada for healthcare, and I would bet those would be the uninsured Americans, or someone who was denied care by their insurance company. But I bet most would be people without insurance, and want to get some free care in Canada. Also, to take advantage of the cheaper drugs in Canada.

But, people from ALL over the world do travel to the US to receive the best care.

So, what do I think about socialized medicine? Well, for starters, it is paid for with taxes. Europeans pay +50% of their income in taxes for the socialized care. It can work efficiently and can be a great system. It can also be a nightmare. It depends on the area, the actual doctors and medical personnel. Socialized medicine seems to be great for caring for massive amounts of lower income people, people who just want the bare minimum in care. When I say bare minimum, I mean be prepared to supply all of your own comforts/supplies in the hospitals (from tvs to maxipads.) There are no private rooms, no fancy birthing suites. Yes, it’s cheap (not considering the taxes you pay), and perhaps you may not care, but it is a no frills system.

Patients are responsible for their own health history, and carry around their own x-rays, samples and files from doctor to hospital, to doctor. (This includes all biological specimens, etc.) Also, you have to give yourself your own shots.

There seems to be very little funds for maintaining the hospitals, and I have seen hospitals with conditions as bad as those we saw at the Walter Reed hospital. Most are old, and in all stages of decay.

You also have to be very pushy with your health care provider. My BIL was suffering from what I thought was an aneurysm due to his symptoms, loss of balance, slurred speech, unable to walk straight, loss of vision in one eye, strange taste in mouth, upset stomach. The doctor wanted to test him for GERD… My FIL got very assertive, and went to the hospital and found his doctor, and explained his sons condition. The doctor ordered an immediate CAT scan and they found a huge brain tumor. Now, the Dr. was awesome, and he got great care. But, had the family not pushed, he would probably be taking Pepto Bismal or something.

My MIL was misdiagnosed for three years, and given steroids which destroyed her bones. She waited four months for a knee surgery to repair the damage to her cartilage caused by the roids. My FIL was diagnosed with prostate cancer, and received fairly quick care. Overall, except for a few bad experiences, I have personally witnessed a pretty good system in Italy.

Another strain on the system is people use the emergency room as a doctors office. Doctors office visits are *private* but you pay ~150 euro. So, many people prefer to just go to the emergency room, where it is *free* (there is usually a small fee for tests, though).

Private doctors and dentists will send you to the hospital for tests, including blood tests, and e-rays, (since most don’t have the capability/expensive machines in their office), where you take a number, and wait. If you are in line at the hospital before the doors open, your wait is only a couple hours. If you arrive there late, you can wait many hours.

When my brother in law was diagnosed as having a tumor with the CAT scan, he was then transported to another hospital for the MRI. He was then transferred to another hospital for the surgery, where the surgeon for tumors worked. The hospitals can’t all afford to have all of the many machines that are needed for diagnosis. These machines are very expensive. Now, I assume a hospital in Milan or Rome would be fully equipped, but from my experience, the smaller ones where I live are not.

There are advantages and disadvantages. A big plus is you do not go in debt when you get ill. But, you have to pay a lot of taxes, and the health industry does suffer. And from what I have seen, there is a big difference in care depending on location, and the quality of people working.

One thing someone pointed out to me is small business owners who provide health care are at a disadvantage when bidding against companies that don’t provide insurance. The bids by companies that have to factor in their health care expenses are at a disadvantage because their job bids are usually more expensive because the competitors aren’t paying health insurance. So, mandates on companies that don’t provide insurance will help level the playing field with small business owners.

Although, I wonder if, when cutting costs, small business owners will choose to drop insurance all together, knowing there is a government option available? (Why is it required that businesses provide insurance, anyway? I can see the benefit of say, a Microsoft, to offer health care to their employees as a benefit, and they probably get a great package, based on the number of employees they have, but for a small business? Do they get more of an advantage, or are they strapped paying for the healthcare?)

I have heard horror stories in Europe and in the US. I hear about long waits, denied care, and botched surgeries in both Europe and America. I hear about people dying, and people being cured in both places. As I said, you won’t find yourself strapped with hundreds of thousands of dollars in dept in a socialized system, but you may find yourself denied care.

One nagging thing that worries me about moving to a government run system is that the US currently has the system in which people from all around the world turn to. How would a government run system affect the system as a whole?

And, as I brought up below, how will the Health Care reform reconcile the costs of Medical School with the new govt. subsidized Doctor salaries.

In American, doesn’t med school run upwards of $100,000+? My husbands cousin spent around $3000 – $4000 for her entire university and med school in Italy. Doctors graduating in America, with massive debt, I would assume expect to earn salaries that will allow them to repay their loans. Under a gov run plan, I don’t see that happening…?

I think there is definitely a need to fix parts of the system – the insurance companies denying/determining care, not your doctor. We need tort reform. The price of medicine is crazy. They need to examine what doctors charge insurance companies for their services/tests. My husband, a dentist, is stunned sometimes when he finds out what dentists bill for procedures in the states. Let’s just say, it is a wee bit more pricey than in Italy.

So, what do you think about the health care reform? And if you are an expat, what are your experiences with health care in Europe vs. America? I have had a good experience with the system here. My husband has some doctors in the family, and friends, so we know the quality of doctors is excellent. :O) But, as I said, we also hear the horror stories.

My point in all of that, is that I do believe the goal of the Obama administration/Democrats is to get to a single payer, government run universal health care system.


I am not trying to influence one way or the other, just offer my personal experience, and opinions.

I think the American people need to demand the facts, educate themselves, and figure out what they believe is the best system for America, and be the *deciders*. For every article I read about how great healthcare is in Canada, I can find two that talk about the horrors. Same goes for the current care in America.

Whatever type of care you think may be best, at least find out the facts of the proposed reform. And demand that members of Congress read the bills! And be prepared to expect your taxes to go up. I can not imagine this system having any chance at success without raising taxes.

  • tzada
  • oowawa

    Ah, the theme song for the new O Health Plan, borrowed from M.A.S.H.:

    The game of life is hard to play
    I’m gonna lose it anyway
    The losing card I’ll someday lay
    so this is all I have to say:

    That suicide is painless
    It brings on many changes
    and I can take or leave it if I please.

    –Johnny Mandel–

    Thanks for the good analysis, American Girl

  • ConfusedAmerican

    I saw this earlier and was totally shocked. I am a senior citizen by some standards and this is what I get to look forward to. HELP!!!

    My mother-in-law got a hip replacement 20 years ago at 70. At 90 she is a bit slower than us youngins but she is doing great. She takes care of herself, home and garden. She no longer drives, but that is probably due to slower reflexes. Would she have been refused her hip repair at 70????

    This is happening frequently in the countries with Universal care and its already happening in America guys.

    WAKE UP AMERICA BEFORE ITS TOO LATE!!!!

  • Tricia Spiegel

    Great report. I am wary about what is happening so fast. Obama seems to want to make a huge slpash as fast as possible.

    My mama always chided me with that old saw, “Haste makes waste” whenever I was trying to do too many things at once.

    I worry that when we look back on the landscape of 2009-2010, it will be littered with debris and flooded with tears.

  • Craig Della Penna

    AGiI:

    Good issue to open for debate but I want to take issue with a few of your points.

    First: Whatever the merits of the quality of the care received by those who can afford it (think minimum six figures) for the vast majority of the US population, there is no effective medical care available unless you are already on Medicare (a ‘socialist’ medical care program for oldsters). I say that because it is SOP in the private insurance industry to make every attempt to deny treatment for anyone who does becomes sick, regardless of how long they have been paying premiums. In a private, for profit, health care system it cannot be otherwise. Paul Krugman has pointed out that private healthcare would not even be possible if Medicare had not siphoned off most of the people who truly need medical care (those pesky oldsters again).
    The simple fact that private healthcare providers have a 20-30% profit margin should be all the information that anyone needs to tell them this is unsustainable, not to mention the obscenity of making profits off of other people’s suffering.
    Second: You make a number of valid points concerning quality of care, overlong waiting times, rural vs urban quality of care, doctors’ salaries, and the costs of medical systems in general – these arguments are good ones. Unfortunately they can be made against every medical system, private or public.
    Third: I am sorry for the travails your relatives had to go through, I’ve had and heard other stories as well, I think we all have. But anecdotes don’t shed much light in this debate. Much more often they’re used as cudgels to stifle debate by the implicit accusation that “if you stand against my position then you must like drowning kittens”.
    Fourth: You mentioned businesses. Very good point – I have always been bemused that American businesses are seemingly OK with bearing the, approximately, 20% cost disadvantage on everything they produce vis a vis their European and Asian competitors. You would think they would be behind single payer 100%, why aren’t they?
    Fifth: I’m sorry to have to tell you that the Obama administration has no intention whatsoever of enacting a “single payer, government run universal healthcare system”. In fact, they are doing everything they can to prevent just that from happening.
    Sixth (and last): I live in Oregon and I think I know what’s actually happened in the case you open your argument with. Oregon had a visionary governor a while back who had actually been an ER doctor. As governor John Kitzhaber was able to get a public healthcare system through the state government. It was set up to care for the poorest of Oregonians who were not covered by Medicare/Medicaid. Subsequent Republican majorities in the Oregon House and Senate lost no opportunity to hack away at the system and finally managed to pretty much gut funding. At the same time, there was the now famous ( or infamous, depending on your position) Oregon Right to Die legislation that has provided end of life choices for, altogether, some dozens of people. I’m pretty sure that the poor woman in question got caught between these two systems: being denied the chemotherapy by one and offered right to die advice form the other. The bad part is that some boneheaded idiot thought it would be a good idea to put both bits of information in the same letter.

    Anyway, thanks for bringing this up, we really should be taking about the subject.

  • oowawa

    This rings a bell with me, Tricia:

    Obama seems to want to make a huge splash as fast as possible . . . My mama always chided me with that old saw, “Haste makes waste” whenever I was trying to do too many things at once.

    German equivalent: “Ein faul Esel trägt alles auf einmal”–a lazy jackass carries everything at once.” My wife usually tells me this when I’m trying to bring 15 plastic bagfulls of groceries in from the car at the same time.

    Trying to do everything at once when you don’t have the strength or resources–not a good idea.

  • http://shhhithitsthefan.wordpress.com/ It hits the fan

    Great post! I just posted one of my own on the same story. Yours is much more comprehensive and better. But mine is much more snarky. Different strokes for different folks.

    The Kevorkian Option

  • jbjd

    Hyperbolic anecdotes, complete with all caps, with double quotes, and an exclamation mark, do not substitute for reasoned inquiry into the pros and cons of health care systems already in place in comparable capitalist democracies.

  • jwrjr

    Any time ANY salesman (like Ozero) says “you gotta buy this Right Now” you know there is something in it that he doesn’t want you to find out about.

  • Tess

    Good post, jbjd: I want to sign onto this: regardless of where you stand on this issue, to make good policy, we must separate pain from pathology, anecdotes from data.

    When you think about it, we do have Healthcare for everyone: it’s called The Emergency Room.
    This needs to be reframed: who will pay for the Healthcare we already have?

    Physicians and Healthcare providers are not allowed, by Federal law, to turn away anyone who shows up who needs care (unless you have a program like the one Michelle Obama wrote in Chicago, where you may legally “dump” patients who can’t pay.)

    These fine distinctions are important. I regularly throw into the trash comparisons between (or among this extraordinary country of America) the USA and what, Norway? Luxembourg?
    Dudes: have you driven across this beautiful land?
    Okay, I’m a little GGGRRR here. Sorry for the hyperbole.

  • jbjd

    Sorry, that was no quotes, but in bold; and multiple exclamation points.

  • WMCB

    AGII, thanks so much for a thoughtful and balanced treatment of this subject. I tend to get it from both sides, because I maintain that ALL systems, here or elsewhere, have their share of problems.

    Those shouting that our system is perfect and needs no changes are ignoring the uninsured, the intrusiveness and OBSCENE profits of the health insurance industry, and many other things. On the other hand, those who want UHC shout down any suggestion that waits and bureaucracy and inefficiency are REAL concerns in countries that have govt programs.

    You can’t get anywhere trying to talk with people on EITHER side of this issue who stubbornly believe that “their way” is an automatic utopian dream. Our system has problems, and many European systems have problems. It would be wise of us to study this closely, look at every combination of public/private or hybrids thereof, and try to AVOID making major mistakes, here – and especially repeating ones that have already been made and backed away from by others.

    We need to look at all of our options and examine them HONESTLY. I want UHC, myself. But some countries have done it better than others, and ALL have had to trade off this or that to get it. Some have made mistakes in going too far, and have moved to correct those missteps. There is no free lunch, not even in our current system. We need to be wary of slogans and demagoguing, and take a realistic look at the trade-offs inherent in any approach, and decide what upside is worth what downside to us.

  • jangles

    Amen to that! One of the glaring things missing from this debate is a well done and informational program on just what is happening in other countries: How much does their health care cost per person? Compared to US?
    What is the life expectancy of different ethnicities and income groups?
    What are the standard medical care/treatments that are generally available to each citizen?
    What is the standard care package for:
    children, expectant mothers, teens, middle age, seniors 65+.
    What care caps are in place for major health issues/ages? (like diabetes, alcoholism, cardio issues?????????
    Most of what I hear are the horror stories from people who are denied care by their insurance companies—what about a poll on that question? Is this a concern and if so for how many people?

  • WMCB

    Yep. We get the emotion-inducing horror stories from BOTH sides of the debate, and very little head-to-head comparison of various systems benefits and costs and drawbacks (and yes, every system has drawbacks, even ours.) How much is freedom from govt intrusion worth to us? How much intruding does the insurance industry already do? How do we stop EITHER ONE from dictating to us excessively, and still get healthcare for all?

    I guess they think we are all too stupid to make comparisons and be rational, or be willing to give up THIS to get THAT, and vice versa. Some honesty would be nice.

    Instead, both sides seem to in a major battle of who can scare us more, or make us feel more guilty (either for the poor uninsured and pre-existing condition folks here, or for the poor hapless “socialism” victims who are evidently dying in droves on the streets from 5 year waits there.)

    I am SICK of the hyperbole. Can we have a rational discussion in this country? Can we please take the time and effort to do that?

  • Marge

    It doesn’t happen in Canada. A friend recently got a knee replacement at 75, and her age had no part of the decision – only the need. Doctors make the decisions, not the government…. and I have never heard of operations or other treatment being turned down because of age. My father had a quadrupal bypass operation at 83.
    Yes, many of our hospitals are older, and if you go you will usually be in a 4 bed ward – unless you are willing to pay a smallish fee for a private or 2 bed room. You will pay for a tv, too.
    I love our system – I find the care wonderful and I can’t imagine worrying about bills at the same time a family member is worrying about health.

  • I’m a Linda too

    It may be already, this explains much…they’re easier to manipulate…

    “27 million American’s on Antidepressants”.

    10 percent of our population, more than doubled since 1996, now on the drugs.

    http://www.alertnet.org/thenews/newsdesk/N03411375.htm

  • shadow
  • shadow

    http://www.youtube.com/watch?v=UOLs7Cybnqw

    TIM BISHOP PROTEST, SETAUKET, NY (part one)

    This is good too. People are finally starting to wake up and speak out.

  • WhatNow

    Comment by Craig Della Penna | 2009-08-03 18:01:58
    Fifth: I’m sorry to have to tell you that the Obama administration has no intention whatsoever of enacting a “single payer, government run universal healthcare system”. In fact, they are doing everything they can to prevent just that from happening.
    *************** There’s a video, the link is from Drudgereport that contradicts this statement. It has Obama speaking at various places over the years.

    http://www.breitbart.tv/uncovered-video-obama-explains-how-his-health-care-plan-will-eliminate-private-insurance/

    Obama, over the years has stated that “a single payer, government run universal healthcare system” is exactly what he wants, but it won’t happen overnight.

  • WMCB

    LOL! He made a mistake when he brought up the VA as an example of a well-run govt system. That old veteran got up and incredulously said, “Have you ever BEEN there????!”

    It got ugly, and it was very obvious how clueless Bishop was about the VA.

  • ConfusedAmerican

    I had a friend that need a heart bypass surgery and had to wait 2 weeks to be transferred and than another 2 weeks…This was Canada. It was not to stabilize him..In fact afterwards he was told he was lucky to be alive, that he should have died during the wait.

    I think for every good story out of Canada, Eng and etc there is a bad.

  • NomNomNom

    He also said he wouldn’t have lobbyists running his campaign, that he wouldn’t support FISA, that he’d repeal the Bush tax cuts, that he’d repeal don’t ask don’t tell, that he’d end indefinite detention without trial, and about a million other lies.
    BHO is not a socialist and not a marxist: he is a fascist. I don’t believe we will ever see single payer under him either.

  • eleana

    Obama Bill= Euthanasia Bill
    The proposed national health care plan would dictate medications, Section 1283 treatments and mental health services,Section 1401-Center for Comparative Effectiveness Research would determine cost effective treatment Section 163 will have access to personal bank accounts, Medical Homes manned by nurse practitioners to eliminate costly hospital stays, Mandatory ‘end of life’ counseling For full article, see:http://www.wnd.com/index.php?fa=PAGE.view&pageId=105525
    If this bill were now in effect, where would Sen.Ted Kennedy be? Oh, I forgot Congress is exempt from this bill, everyone else, it’s mandatory.

  • NoBamaNoWay

    you said it, Craig.

  • Barry

    American girl in Italy,

    Are you being paid by the insurance companies?

    Why are you even commenting on the state of healthcare in the U.S.?

    Why don’t you tell us how great your public healthcare system is in Italy?

    Easy to sit they and try and stop healthcare reform in the U.S. when you have access to a very good public healthcare system in Italy. What a shrill for the insurance companies you are and hypocrite.

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    Good reply but I want to take issue with a few of your points, too.

    “First: Whatever the merits of the quality of the care received by those who can afford it (think minimum six figures) for the vast majority of the US population, there is no effective medical care available unless you are already on Medicare (a ’socialist’ medical care program for oldsters).”

    I, and everyone I knew living in WA, and worked with, sick and healthy, had/have great healthcare. I don’t get your point here. My 80 year old uncle, and aunt, are still covered via Boeing, and have EXCELLENT coverage. My family and friends were all covered through health insurance at work, and I don’t think there was anyone in that group making 6 figures. And I never knew anyone personally who was denied care. I have seen stories on the news, but never knew anyone, ever.

    “Second: You make a number of valid points concerning quality of care, overlong waiting times, rural vs urban quality of care, doctors’ salaries, and the costs of medical systems in general – these arguments are good ones. Unfortunately they can be made against every medical system, private or public.”

    I believe I said that in my post.

    “Third: I am sorry for the travails your relatives had to go through, I’ve had and heard other stories as well, I think we all have. But anecdotes don’t shed much light in this debate.”

    I have been asked NUMEROUS times to give my personal opinion on my experiences on Italian health care, so I think my anecdotes fit perfectly in my post. That is the point of my post, as I stated. I also believe that my anecdotes are fairly positive of the Italian system.

    “Fifth: I’m sorry to have to tell you that the Obama administration has no intention whatsoever of enacting a “single payer, government run universal healthcare system”.

    And you know that how, exactly? How do you explain all the comments he has made, as well as the others in the video above?

    “Sixth (and last): I live in Oregon and I think I know what’s actually happened in the case you open your argument with.”

    I’m not making an argument, which I believe I also included in my post. But, what happened to that woman happened in a government run health care program.

    “The bad part is that some “boneheaded” idiot thought it would be a good idea to put both bits of information in the same letter.”

    We’ve heard that term a lot…

    Obama is a proponent of single payer:

    http://www.youtube.com/watch?v=fpAyan1fXCE

    http://www.youtube.com/watch?v=iswGYeAebWM

    And for someone who *has no intention* he sure talked a lot about liking it, and wanting to implement single payer…
    http://www.youtube.com/watch?v=l7wTDK-LwqE
    http://www.youtube.com/watch?v=cnLFdVt9egA
    http://www.youtube.com/watch?v=aDAPLb-HVcM

    He has also said he will not raise taxes…

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    “Why are you even commenting on the state of healthcare in the U.S.?”

    because I am an american citizen, and my family lives in the US, and I give a shit.

    “Why don’t you tell us how great your public healthcare system is in Italy?”

    Why don’t you try reading the posts before you dump your verbal diarrhea all over the place.

  • NoBamaNoWay

    oh…. the Fraud “said” he “wanted” single payer…. heh. i’m “saying” that i “want” to sell you a bridge….

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    I am with you 100%!

  • WMCB

    Exactly. One can’t say definitively that Obama is for single-payer. As with many issues, he is all over the board on that. Because it has always depended on and changed with:

    a) what group he is talking to and

    b) how much campaign money he will be getting from that group.

  • http://deleted BuzzisbackLatte

    Hey Barry,

    We’ve put your name in for Obamacare euthanasia. We’re sure you won’t mind. After all it’s for the liberal messiah cause!

    Oh, it hasn’t become law yet?

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    Thanks!

    One problem that I hear about in Italy is the difference between the north and south. According to the northern italian, the south doesn’t report near enough of their taxes, many people working in the *black*. So, the southern half of the countries system suffers (not just health care) and the money is always being filtered from the north to the south to cover their shortcomings.

    If the system were efficient, and the taxes and funds were adequate, I think universal coverage can be a great thing. I worry about the governments ability to handle it, considering the bang up job they have done on everything else. ahaha

    But seriously, I used to really believe in UHC, and want it for America. And I believed the Dems *cared* and were the ones to bring it. But, after all the crap I saw go down, and ALL the corruption and scandals that have come out with Dems lately, I don’t trust them anymore.

    They are just as corrupt as I thought the Repubs were, or worse. I don’t trust any of them anymore.

    It needs fixed, no doubt. Both systems have flaws, and corruption, and benefits. We need to figure out the best way to fix it. :OS And who knows, maybe this plan is it, but I don’t like the way they are pushing it through, and that no one has read it, or has a clue what it means! that is wrong!!

    I also disagree that they should only tax the rich for healthcare. I think if health care is going to be universal, then all Americans should contribute into the system. Or they should tax those who USE the gov. health care system. But taxing only some people, who won’t be using it, to pay for others who won’t be paying HC taxes, but use it, seems wrong.

  • WMCB

    Hubby is a doc, and has practiced in Italy. There is spotty care in a lot of areas. And a lot of Italians get around that by using private clinics or private doctors for some stuff, the public plan for others. Still, they are glad no one goes totally without care.

    There are pros and cons.

  • http://shhhithitsthefan.wordpress.com/ It hits the fan

    As an ex-expat I would like to describe the care I received in a socialized medicine state.

    A few years ago I lived in Belgium. I was able to get health care the second week of my stay. I lived in a small village that had it’s own doctor. It cost me 10 euros to see him. I could make an appointment but it wasn’t necessary. And if I was too ill to see him he would come see me. And he would call me to make certain the medications were working and I was getting better. When I ran into problems with some workers that harassed me because I was an American, he told me I was being discriminated against and called the company doctor to let her know of the incident. This was right after Bush decided to invade Iraq. The company doctor informed the director of the company that discrimination was not to be tolerated and had him write a letter to my supervisor informing her that such behavior would not be tolerated.

    So my experience with socialized medicine was a very good one. Of course there were quirks that would probably make most Americans paranoid. When I missed a day of work because of illness, a representative of the insurance company would stop by to make sure I wasn’t faking it.

    So where does this leave me in my opinion of the US health care system? A little perplexed. Once I had injured my back severely and was receiving treatment 3 or 4 times a week. The company I worked for was pressured by their insurance company to try to reign in costs. My employer attempted to get me to cut back on the care I needed and finally laid me off for no good reason. I went to see my doctor as usual and while he was examining me I told him that I had just lost my job and would need to make payment arrangements. He literally stood up and walked out of the examination room without a word. A few minutes later a nurse came in to inform me that the doctor could not treat me because I didn’t have insurance and I would have to leave.

    So do I think we have the best health care system in the world? Hell no. It’s screwed me over big time. The lack of care messed me up for life.

    The system in America is good for some people and not so good for others. Personally, I would support a single payer system where there was a basic standard of care that ALL CITIZENS received. If we wanted more enhanced care we could buy into a plan with our own money. But it wouldn’t work unless the insurance companies were REQUIRED to allow all citizens to buy into it equally. That would lower the cost of it immensely. And if someone wanted elective ego surgeries to enhance their breasts (or penises), tighten their faces, change their gender or whatever, then people could pay for such a plan out of their own pockets. That type of system seems fair to me.

    I totally disagree with how the current Administration is going about things. They are trying to rush through something most elected representatives haven’t even read. And they are being prodded by an Administration that is imposing artificial deadlines merely for the sake of Obama’s ego. It’s all political, that much I am sure.

    I don’t know that I have answered any of your questions. But this is how I feel about it.

  • WMCB

    Oh, and I agree that the healthcare tax if we need one should be across the board. Everyone needs some skin in the game. You can make it progressive, with higher percentages of income paid by those at the top, but everyone still needs to pay SOMETHING, even if it’s just 1%

    Many countries don’t even do that. I think Poland has basically a flat 7% tax on everyone to run their system.

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    Great input, thanks!

  • CG

    Thanks AGinI.

    I lived in France (Paris) for 4 years with a permanent work visa. We did not have any bad experiences, no horror stories, with the French health care system. We did not pay +50% for health care. We got to choose any doctor and had no long waits for medical appointments. Personally I appreciated the simple income tax report too.

    In America, with Microsoft insurance, a very generous plan by the way, we are limited in terms of choice of doctors in the plan, and there are annoying procedures to see specialists or to obtain permission to visit emergency or to obtain permission if you are say traveling on business and need medical care. The waits for routine care are a month. To be clear, although Microsoft generously assists with the premium, employees contribute to the premium every paycheck. The coverage is not 100%, there are limitations and you may receive a bill from the doctor if they feel the insurance company did not sufficiently reimburse.

    I will spare the details of nightmares my mother and brother in California have endured, both contribute to fairly high end insurance plans, with misdiagnosis and dangerous prescriptions (prednisone), to long waits for surgery while in extreme pain (brother), and outrageous costs and expenses to them. Neither was for life-saving treatment, imagine the anguish if their lives were on the line.

    I would say the current health care system in America absolutely does not work better, it’s just more expensive. I am grateful to be healthy, though a fairly healthy person can die in an American hospital. And you’ll never convince me that an insurance company can manage health care. And let’s take it a step further, how well did AIG do, and why the hell did we have to bail them out?

  • HARP

    You need medication for your mental condition Barry. It`s a shame you won`t get it on the public option. I guess you will just have to stay fucking nuts.

  • Marge

    There will, of course, be people who are not happy with the care they get. I have never had poor care – not me or my three children or the eight grandchildren – or the work colleagues or all the friends I have made over the years. I would put the bad stories at perhaps 5% – maybe less. It was thought that I had cancer – I had immediate MRIs, an operative biopsy and follow-ups with another MRI – all within days of the discovery. No cancer – but no cost. My daughter had difficulties with her pregnancies – and was sent immediately to the best woman’s hospital in the province. My son had eye surgeries (a hockey accident – what else!), a grandchild just visiting got the mumps and simply went to a local clinic. All services prompt and free.
    I have never heard a serious complaint about our system from people I know – in all my life.

  • LDW

    (I also posted the following on another site)

    Single payer insurance, which would take the Insurance industry out of the primary care business, would lower costs and cover everyone.
     
    Even a hybrid system, like the Swiss have, would mean everyone is covered, including children and the unemployed. The Swiss strictly regulate what the insurance companies can charge, and you pay according to your age group (everyone pays the same, even those with pre-existing conditions); and the companies cannot refuse coverage to anyone: the government thereby allows the insurance companies to profit only by their own internal administrative economies. There is a government fund to compensate companies who have accumulated large numbers of expensive patients, but they must provide proof that they were paying a larger than ‘normal’ percentage of expensive treatments.
     
    Americans are now (as they were when Hillary Clinton proposed her reform package) being treated to horror stories about how socialist medicine will ration care and take away freedom of choice, but this is nonsense.  In Canada, for example, people choose their own doctors, and can also be served at the day clinic or emergency room of their choice. Most doctors and many clinics are independent, private businesses.  They see patients and send their billing to the Health Insurance administration, that pays them on a fee-for-service basis. Canadians are free to choose their own doctor, and the doctor is free to decide, in consultation with the patient, what course of treatment to follow. No corporate insurance bureaucrat has to pre-approve procedures or tests.
     
    Are there problems in countries with single payer insurance programs that cover everyone? Yes, of course. In every large organization involving humans there are bound to be mistakes and outright fraud. But the insurance industry in the United States also has many problems with mistakes, fraud and corruption, and the results shown by the health and lifespan of the populations in Single Payer Western democracies is considerably higher than in the United States, and for about half what the USA spends, even though over 40 million Americans are uninsured and probably twice that amount are underinsured.
     
    The Obama healthcare plan was written in consultation with the Insurance and BigPharma industries, and single payer proponents weren’t even given a seat at the table. The ‘Public Option’ part of Obama’s plan has been gutted to the point that the Insurance Industry is happy, happy, happy. The Obama healthcare plan will simply pad Insurance Industry profits, because it will force all Americans to buy coverage at rates dictated by the insurance industry and will subsidize many of the new policyholders. Obama has not made any provision in the legislation to control prices by bargaining or by putting a ceiling on profit margins, either with the insurance companies or the drug companies, and, in fact, any government control of prices is strictly forbidden by the legislation.  Even with the generous conditions given to the insurance industry, the universal coverage aspect of the legislation won’t kick in until 2013, and even then,  not everyone will be covered.
     

    Americans would be foolish to accept the Obama plan, in my opinion, because it throws huge amounts of money – we’re talking TRILLIONS of dollars here – at a system which is already costs at least double what other Western democracies pay for healthcare, and which leaves about 15% of Americans without insurance, and leaves twice that amount underinsured. The present system, in other words, is failing half of Americans and costing twice as much as other Western democracies pay. Obama is getting ready to simply pour more money into this broken system, and is proposing nothing realistic as far as cost control or increased adequate coverage is concerned.
     
    Americans should be taking to the streets to get the insurance industry out of the primary healthcare business, and bring in a reasonable system of single payer insurance.

  • Marge

    In all my life, my 3 kids and 8 grandchildren – my many colleagues and friends – I have never heard a story that blamed our health system or wished it was different.

  • http://deleted BuzzisbackLatte

    Really, isn’t the friction more about the government takeover of a section of the economy rather than in the trenches stories about healthcare of the lack thereof?

    The fight is really about freedom rather than bad insurance companies. And if the government can screw up healthcare as well as they have screwed up education with special education and No Child Left Behind, isn’t it rather prudent to be more than a little suspicious?

    And before you jump all over about Special Education, try doing the paperwork, keeping the paper trail, and meeting all the federal, state, and district level requirements just once. You’ll then understand. And by the way, that’s in addition to teaching the students.

  • http://deleted BuzzisbackLatte

    Thank-you.

    The biggest complaint is the cost and in some cases being turned down for pre-existing conditions.

    Don’t buy the liberal/socialist hype about a broken system.

  • Ellen D

    I paid a small fee and had private rooms in Canada for both my pregnancies.
    My father had cancer at 76 in Canada and got immediate treatment at the cancer hospital.

    Down here, my daughter, who is pregnant, priced “birthing suites”. It was way too expensive and completely unaffordable. She makes more money than me – enough in fact to be in trouble if Obama’s tax raise goes through, but she said the prices were movie-star prices.

  • Ellen D

    I have always been bemused that American businesses are seemingly OK with bearing the, approximately, 20% cost disadvantage on everything they produce vis a vis their European and Asian competitors. You would think they would be behind single payer 100%, why aren’t they?

    As a business owner in Canada, the U.S. and Europe, I have raised this point many times.

    Now with the internet, I recommend every business owner in the U.S. go to Government sites in all the countries that have Single Payer and see how much it would cost them in employee health care if they set up shop in those countries. I’m not recommending you actually move but use it for a comparison.

    Many thanks to American Girl for your comments. I saw you comment many times on U.S. health care and wondered what you would say about Italy.

    As for being a pushy patient’s advocate, I think you need to do that everwhere.

  • Ellen D

    Remember the Supreme Court gets criticized for looking at what other countries do. Thank you for a vote against provincialism.

  • Ellen D

    I worry about the governments ability to handle it, considering the bang up job they have done on everything else.

    Oh no, not this again. You’re too smart for this, AG. Medicare is being handled just fine.

  • TeakWoodKite

    Great read American Girl in Italy, including many of the comments.

    Out of all it, I have been puzzling after how is a doctor to be paid and if the special skill set they have will bear a market rate or some “board” will control what they earn?

    I mean if “it’s the Doctor” means he got in his Tartus and left the building, who will tend to my wound? An insurance comapny clerk?

  • BlueTopaz

    The anti-Americanism during Bush and Iraq was really bad in Holland, too. I can empathize.

    In America, when you anwer ?s about pre-existing conditions, you might not disclose them for fear of losing coverage. In Europe, you tell the truth because it’s healthier and common sense to inform your care givers of the facts. This alone saves money and lives.

    Of course, no system is perfect, but per capita, Americans spend more for health care, and a large % of that capita isn’t even getting coverage! We have one of the worst infant mortality rates of all the industrialized nations and Europeans’ life expectancy is higher than ours. Considering their seniors suffered through homeland war, food shortages, etc., that’s amazing.

    One thing that surprised me in Holland was that a woman’s “spread ‘em” physical was done by the GP instead of a Gyn like in the US. When I mentioned this, the GP said a Gyn wouldn’t be doing anything more than she would for a yearly pap. If there was a problem, I’d see the specialist. This made sense. We pay nurses to take BP, draw blood etc. We pay GPs for general care and we pay Gyns to “perform their special kind of love” (or whatever is was that W. said, lol).

    Then when I got back to the States, the insurance co. I had did the same thing! But I guess it depends on the insurance.

    I definately prefer the Dutch system and can’t wait to get back to it. I hear Finland’s is really nice, they do have birthing suites there, with plenty of room for family to stay.

    It’s the blood sucking insurance and pharma companies that have to be dealt with before any real progress can be made in the US.

  • http://wheninrometours.blogspot.com regina

    The European model can indeed be a good one…except for countries like Italy where because the vast majority dodge paying taxes, the “suckers” who do pay get hit with more than 50% income tax. How are small businesses supposed to compete and survive that way?? It is impossible.

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    I wasn’t speaking specifically to medicare, but the government in general,and the many scandals we have seen, and the problems they have had, the C4C program being the latest.

    But, I don’t think Medicare is without problems either.

    “Medicare fraud has long been a criticism of the program, with its size in part a factor in the ability to “game the system.” More than $800 billion is spent annually on Medicare and Medicaid, the joint federal-state program for the poor, and by some estimates more than $60 billion each year is lost to fraud.

    http://online.wsj.com/article/SB124888553192790663.html

    Obama has also freaked a lot of people out by talking about cutting back on Medicare.

    And reports that Medicare and Social Security running out of money suggests there is a problem. Medicare is expected to be out of money in 2017.

    http://www.washingtonpost.com/wp-dyn/content/article/2009/05/12/AR2009051200252.html

    People seem to be quite pleased with the system, but it is going broke.

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    I’m talking about the rate of taxes that are paid overall, part of which funds health care. I don’t mean an additional 50% for health care.

    http://en.wikipedia.org/wiki/Tax_rates_around_the_world

    http://en.wikipedia.org/wiki/Taxation_in_France

    Perhaps France has a better health care system than Italy? I think I said in this thread somewhere, I think universal health care can be a great system – I just think we need to make sure if is funded correctly, and adequately. If there is enough money to pay for it, it can be a well oiled, funded machine… But I believe, my personal opinion, that if you don’t invest enough money/taxes into it, it will suffer.

    In addition to going to a universal system, I think they need to work on priced of drugs, the amount of lawsuits, etc…

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    Can someone confirm for me:

    The Congress has a govt. run insurance plan, correct?

    VA Hospitals are govt. run health care.

    Italy/Canada have govt. run health care.

    Medicare is government run health care insurance?

    Obama’s HCR is govt. run health insurance, correct?

    It seems that these are two different things, and get muddled in the discussion. A govt. insurance plan is not the same as govt. run health care.

  • Ken in IL

    Congress needs Oregon’s healthcare program since they don’t want term limits.

    Chris Dodd should buck up and show everyone he believes it this sort of care and let his prostate cancer run its course. He will still have 3-4 more years.

  • NomNomNom

    Marge is in Canada :)

  • Prisoner24601

    Thank you for the thoughtful article. You raise a lot of really legitimate issues. It’s really helpful to hear the perspective of someone who has experienced both systems.

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    Thank you! That’s all I was trying to do. :O)

  • FrenchNail

    France has a two speed system. The public one and the Private one. Every single specialist has a private practice. If the patient want to have a speedy care and a more comfortable and more sophisticated care, he goes to the private consultation out of the public system. He pays anything above what he would have paid in the Public system out of his own pocket or through supplemental private insurance.

    This system works on the Health front, meaning everybody is insured at least basic care even in life threathning situations. But on the Economic one, it is a DISASTER. The Public Health Care system is permanently banckrupt, running deficits as large as its budget. The taxe burden on every French salary and business is enormous and has crippled the entire economic growth.

    But more insidiously, it has created a sense of entitlement completly contradictory to the American spirit. The true opposite of JFK’s Ask not what your country can do for you, Ask what you can do for your country.

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    thanks for your input!

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    The undeniable reality is that you can’t run a European-style welfare-entitlement state without European-style levels of taxation on the middle class (and eventually without low European-style growth and high jobless rates). It’s looking more and more like Mr. Obama’s no-middle-class-tax pledge was one of the greatest confidence tricks in American political history.

    http://online.wsj.com/article/SB10001424052970204313604574328552267381152.html?mod=googlenews_wsj

    http://www.msnbc.msn.com/id/3036789/vp/32281727#32281727

  • tango

    Repeal income tax and implement a flat sales tax. That works for me.

  • mary

    American Girl in Italy!

    Thank you for a good post, but I disagree with you on just one thing.

    Yes, some Americans may visit Canadian hospitals/clinics because they’re ‘free’, but you cannot really say that those who visit U.S. hospitals/clinics do it because they are “the best”.

    I am the recipient of the BEST CANADIAN healthcare for the last 2 decades and trust me, I could not have wished better or more caring or more ‘PREVENTIVE-oriented healthcare than the one my family receives in Ontario, and throughout Canada.

    Since l965, thanks to a guy who was voted as “the Celebrity Most Famous Canuck”–Tommy Douglas, son of a Baptist Minister from Saskatchewan and long dead!

    Canadians cherish their system because, unlike the American profit-driven Darwinian Jungle’s it is meant to HEAL people in a humane, compassionate way. My cousin was diagnosed for colon cancer and even tho it was extremely difficult it was done laparoscopically at a teaching hospital in Toronto. Cost: Ambulance ride and parking tickets.
    EFFICIENCY of Canadian system is not in dispute.
    GPD share in America for all healthcare: l6%. Canada’s share is only 8%. Per capita: U.S. $7,000; Cdn: $3,400.00.
    If any Canadian politician decided to mess around with National Health Care his fate would be Doghouse Chief. No way; the conservatives, liberals and the new Democratic party are all in favor. But the reason Canucks got their National Health cAre back in l965 is because their Liberal (Pearson was Prime minister and Nobel Peace Prize Winner) Government was a Minority government and the third Party (not the Conservatives, of course!) was a Social Democratic one. It helps to have 3rd Parties….
    God Bless the Canadian hospitals, doctors and nurses. They’re truly the BEST and have saved lives with the most advanced application of their knowledge and skills–world-renowned. Please DON’T BELIEVE the nonsense.

    Read about American Lawyer Diane Watkins in N.Y. Times (Nic Kristof) who immigrated to British Colombia, Canada to avoid Bankruptcy due to medical bills….
    UNIVERSAL SINGLE-PAYER is the most cost-efficient and human way. Get rid of these Insurance VAMPIRES that prey on the sick and vulnerable. Now is the time.

  • Doc99

    I would expect the next AARP convention to be an entertaining affair.

  • Doc99

    The Supremes should be criticized for making rulings based on anything other than the US Constitution.

  • Carlaforhillary

    Thank you for you post. Even though you seem to point out some good things about the healthcare system in Italy, to me it seems like it not good at all. Why would I want to give up what I have now for that?

  • CG

    But more insidiously, it has created a sense of entitlement completly contradictory to the American spirit.

    Umm… paying +50% is an insidious sense of entitlement?? Yes, while in France we also had supplemental coverage but never needed to utilize it. Many seniors on Medicare purchase supplemental coverage too. There are Medicare withholdings on our American paychecks, we are paying for our future use of Medicare insurance once we are retired and do not have access to a plan otherwise. And right now American health care is rising 3 times the rate of inflation, how is that a successful model? Right now our cost for medical care ranks the highest in the world, leaves out 46 million uninsured, millions upon millions of underinsured, with a million insured and uninsured Americans filing for bankruptcy over medical expenses. Ask not what your country can do for you, Ask what you can do for your profiteering health care corporations.

  • Carlaforhillary

    Thank your for you post. Even though you seem to point out some good things about the healthcare system in Italy, to me it seems like it is not good at all. Why would I want to give up what I have now for that?

    Had to re-write that.

  • Katmoon

    Maybe a good comparison would be to examine how health care is delivered on reservations; just a thought, it is “free” after all.(snark)Or how about veterans hospitals? It wasn’t that long ago many were under the gun for some serious breaches in care. My question is, if we don’t take care of our soldiers or our native people, why should we think it would be any better care delivered to anyone else. The care that is “free” is already doled out in a class-style fashion. I wonder, who will rate what care under this plan.

  • CG

    What has crippled economic growth in France, the United States and European Union, causing this terrible recession, is the conduct engaged by investment corporations, banking corporations and insurance corporations that the taxpayer is bailing out, a debt that the taxpayer’s children will pay, a debt that the taxpayer’s grandchildren will pay as well. Ask not what your country can do for you, Ask what you can do for your irresponsible corporations that just wiped out your 401K’s and pensions and now you have to bail them out and give them guarantees to purchase undervalued assets so they can turn huge profits. Now that’s the American Spirit! The insideous entitlement of American corporations, and we are footing the bill for corporate welfare, meanwhile

  • CG

    (con’t.) meanwhile they are collecting outrageous bonuses for their handiwork which is taking its toll on our economies and potential for growth.

  • http://sarainitalyblog.blogspot.com/ American Girl in Italy

    I have read and known of people from all over the world who travel to the states for the expertise, and treatments available in the states. When people have *untreatable* conditions, mysterious illnesses, birth defects, etc… they come to the US for treatment. If they have an illness that is treatable just fine in their country, they don’t need to come to the US, but people seek out the *expertise* and advanced medicine the states offers a lot.

  • Juliet16

    or so she says…

    Obot troll?

    Possible…

  • nobody special

    AGII

    Congress members have private insurance. They choose from a collection of plans that the government contracts with to provide health care for all federal employees. The government pays a portion of the premiums and the insured in this case the member of congress pays a portion of the premiums. The plans provided are all of the HMO or PPO/PPC variety. In other words there are networks of providers by contract and in order to get optimal coverage one needs to stay within that network. This system works well, except when contracts with hospitals have holes in them where some services are not covered. This happens with most policies it’s just that most Americans thankfully have never fully tested their policies.

    The VA is a fully run government health care system for veterans.

    Medicare is a government insurance policy or social insurance I think would be the better term. Recipients see private doctors and go to private hospitals but the government guarantees payment.

    Interesting article. Personally I’m sick of all the hype too. There is good and bad in every kind of system. For every horror story from Europe I could find one here in the US. Only difference is in the US it’s an insurance company in Europe more often than not the government. For some reason it’s the horrific rationing if a government denies something….but it’s just good business if an insurance company does it. I think both instances should be looked at objectively and without hyperbole.

    I agree with many of the comments up thread. Why can’t we all take a collective deep breath. Take the time to look at all kinds of systems, what works and what doesn’t. Then try to learn by example and build the best system for our citizens.

    I believe our system is broken in many ways. Anyone that doesn’t believe that hasn’t had the unfortunate circumstance to truly test their policy. I understand, I felt that way a few years ago myself, but tragedy struck our family and even with good insurance we went deep into debt. We also had to fight tooth and nail with the insurance company over basic stuff like chemo. I can’t tell you how many times chemo drugs were denied and it took months to get the bills paid, but hey at least those bills were paid unlike some of the other bills.

    There has to be a better way and I’m open and willing to listen to all sides. I’m not married to any answer and in fact perhaps the best answer will probably be a uniquely American one. I am intrigued with systems like Japan which are similar to the Swiss system described above. Everybody has insurance, doctors and hospitals are private not government employees, insurance industry is heavily regulated like our utilities are for instance. That sounds like it might have promise sort of a half way point between full government and full private system.

    So that’s my two cents

  • http://sarainitalyblog.blogspot.com/ sarainitaly

    those are great two cents! :O)

    I agree it’s broke, and needs fixing. Decisions are made by insurance companies to not cut into their profit, decisions are made by government run health care because funds are short – that’s my guess.

    They need to figure out why drug companies charge so much, too. It is CRAZY the costs they charge.

  • nobody special

    Drug companies charge so much supposedly to cover research and development. There are two separate costs associated with any drug. One for R & D, and then the actual cost of manufacturing the drug. The final price is derived from both. Countries with universal, socialized, government run whatever you want to call it health care agree to a set price for drugs for their population.

    Those prices are typically cheaper than what we pay here in the US even though many of the drugs are developed and made here in the US. The drug companies gouge us a little more to offset their “losses” from selling to government systems. So in essence we subsidize most of the world. If we were to move to a government type system here our drug costs would no doubt come down, but costs would surely rise around the rest of the world.

    Also, a drug company can charge more so long as they still hold the patent. Once the patent expires typically after 10 years then other companies can make a generic and there is competition. The system is set up that way because otherwise drug companies would never recoup their investment without a patent which are for the most part recognized worldwide with a few exceptions. A company can apply to have a patent extended and that happens too often as far as I’m concerned but that’s just my opinion.

    It also gets on my nerves that not only do we pay higher prices for our drugs here in the US, think about federal dollars that go to R & D in the form of various grants. So you’d think we’d get a break due to that, but we don’t.

    I think there is certainly some room for improvement with the current system we have, DUH! But when part of the issue revolves around other countries and other systems it becomes a sticky wicket in some ways.

    Many opponents of a universal health care system here in the US insist if we put all drugs under a contract price like other countries then money for R & D will simply dry up. I’m sure there is some validity to that and something we should think about and weigh heavily. But I think some of those claims are a bit exaggerated drug companies in Europe still develop and produce new innovative drugs, just not at the pace their American counterparts do. I for one don’t want to be a party to killing the goose that laid the golden egg, but I certainly know all too well the undue burden expensive medications can put on a family.

    I’m not defending big pharma here trust me I know how greedy and heartless they can be and they’re certainly not hurting for profits. But the effects any kind of reform might have on lifesaving drugs in the pipeline and those yet thought of is certainly something the best and brightest minds should sit down and discuss before we completely revamp anything. I’d like to think all possibilities have been tirelessly thought of and solutions derived….ha, ha….I’d also like to think I have the winning lottery ticket in my pocket. Please Congress can’t even read this bill let alone think through all the what ifs.

    I have an idea though. Since big pharma has clearly gotten their monies worth out of their investment in viagra and other such pills….I say we put a surcharge on boner pills….name your price and all those revenues go into R & D for lifesaving drugs. Snark! Just a thought, maybe we’d see less commercials for them! Hey if they can tax botox they can tax boner pills, just sayin.

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